[Myoelectrical appraisal of the operative procedure with preservation of the right gastroepiploic neurovascular peduncle in selective gastric vagotomy plus antrectomy].
The purpose of this study is to investigate movements of residual stomach after selective vagotomy plus antrectomy (SVA). Electromyograms (EMGs) were recorded chronically from the stomach and intestine of unanesthetized mongrel dogs using 4 different procedures: (1) sham operation (control), (2) SVA with preservation of right gastroepiploic neurovascular peduncle (SV+A'), (3) SVA with peduncle transected (SV+A) and (4) antrectomy alone. The results were as follows: 1. Migrating myoelectric complex (MMC) appeared less in SVA dogs, while frequency of basic electric rhythm (BER) with spike potentials (SP) per MMC period in the duodenum was normally maintained in SV+A'. 2. Postprandial ectopic excitation occurred in SVA, but less frequently in SV+A' than SV+A. SV+A' dogs showed a slower propagation of BER than control, but percent changes from the control nearly equaled that of antrectomized dogs, while in SV+V it was more slowed. 3. Under insulin hypoglycemia, occurrence of BER with SP was normally maintained in SV+A' dogs, but in SV+A it had apparently decreased, suggesting that the cholinergic nerve fiber was in the peduncle. A comparative study was also made of EMG responses to insulin hypoglycemia among SV+A' dogs. The results suggested posterior vagal truncus carries cholinergic fibers to the right gastroepiploic nerve. In conclusion, preservation of the right gastroepiploic neurovascular peduncle had the advantage of preventing the retention of gastric contents following SVA.
Kato
T
T
First Department of Surgery, Niigata University School of Medicine, Japan.
D000818:Animals; D004285:Dogs; D004576:Electromyography; D011706:Pyloric Antrum / Q000601:surgery*; D013270:Stomach / Q000098:blood supply* / Q000294:innervation / Q000502:physiology; D013514:Surgical Procedures, Operative / Q000379:methods; D014629:Vagotomy, Proximal Gastric